The opioid epidemic: How an Ohio fire department is there for addicts ready for help

Former addict, kept alive by firefighter/paramedics, now part of an Ohio community’s approach to stem the opioid crisis

While I don’t regularly make EMS calls anymore, I do try to keep my skills and continuing education requirements up to date. But I also remember times when getting up to handle an “EMS lift assist” in the middle of the night was not one of my favorite duties. Let’s face it, there are just times when handling an EMS call from the same patient with the same chief complaint several times in a day, or within the same week, may warrant that patient being labeled a “frequent flyer,” creating a tendency to dismiss the call as not a real emergency.

A current example of such an emergency run might be repeated calls for the same patient, unconscious or overdosed on opioids. It’s sometimes hard for all of us to understand why a person may continually put themselves in a near-death state through their addictions, while gambling that we as firefighter/paramedics will arrive in time to administer naloxone to bring them back from the abyss. Unfortunately, we may get so frustrated that find ourselves wondering, “If they don’t care, why should I?”

Enter Amy.

A current example of such an emergency run might be repeated calls for the same patient, unconscious or overdosed on opioids. (Photo/DoD)

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Recovering addict offers perspective

Amy recently provided one of our department’s monthly EMS continuing education programs. Amy is 36 years old and serves as the community outreach manager and peer recovery support specialist for an addiction rehabilitation agency in our area. She is also a recovering addict.

Amy became addicted to prescription drugs at the age of 14, following several surgeries on her knees. For several years she was prescribed painkillers for what she realized, in retrospect, were what she described as “phantom pains.”

Her addiction made high school very difficult. She eventually dropped out, although she continued to study and ultimately obtained her GED at 16.

For the better part of the next two decades, Amy wandered Midwestern cities looking for her next fix, and became entangled in most every form of addiction available during those years.

In 2012, Amy overdosed on black tar heroin in the car of her drug dealer, and was subsequently pushed out onto a street to die as the dealer sped away. What saved her life? A team of firefighter/paramedics who were able to revive her and get her in time to the hospital.

While not immediately, Amy began to realize that she was alive for a reason. Although she had outstanding warrants in Ohio, including several felonies, she returned to her hometown to try to start a new life through rehabilitation. Eventually, however, her past caught up with her, and after ending up in a holding cell, she realized that the only way to really remain clean was to pay for her past mistakes and try to start anew.

Fire department projects to stem opioid crisis

Today, Amy is not only a community outreach manager, she is also an integral part of the team of counselors that has partnered with our department on two major projects to stem the opioid crisis in our community.

The first is the Quick Response Team, which consists of a firefighter/paramedic, a police officer and an addiction counselor. The team members either respond directly to an overdose or non-breather emergency call or follow up within hours of the call to offer the patient an immediate opportunity to enter a rehabilitation program. Our QRT program has now been active for four years and handled several hundred patients, with an approximately 72% success rate. (“Success” here is defined as the number of patients contacted who are then placed in the program.) One secret to this program is the follow up by the addiction counselors who spend personal time with each client to help them remain clean.

The second program adopted by our department is the Safe Station Program in which an addict can come to one of our fire stations 24/7/365 and request to be placed into a rehabilitation program. The Safe Station Program successfully began in Manchester, New Hampshire, and after obtaining more information on the operation from the Manchester Fire Department, seemed to be a natural extension to our Quick Response Team concept.

When an individual comes to a fire station, a pair of on-duty firefighter/paramedics places them in a safe area and conducts a medical field intake assessment of the patient, similar to someone coming to the station with a medical emergency such as chest pains. Following the medical assessment, the patient is either transported to an appropriate medical facility for treatment of their medical condition, or contact is made with the Addiction Services Council of Cincinnati for transport of the patient to one of its facilities to immediately begin the recovery process.

Amy is one of the professionals who the recovering patient will meet on their first and roughest day, because she knows that each new day is the most important to recovery, and that recovery is always one day at a time.

Remember Amy on opioid calls

So the next time one of us administers naloxone to an unconscious patient and wonders if it’s worth it, think about Amy, who is most grateful for those firefighter/paramedics who brought her back from the dead and subsequently offered her a chance—a chance that has resulted in her not only being a recovering addict, but one who is determined to help every addict willing to attempt a recovery of their own.

Stay safe!

About the author

Chief Robert R. Rielage, CFO, EFO, FIFireE, is the former Ohio fire marshal and has been a chief officer in several departments for more than 30 years. A graduate of the Kennedy School's Program for Senior Executives in State and Local Government at Harvard University, Rielage holds a master's degree in public administration from Norwich University and is a past-president of the Institution of Fire Engineers – USA Branch. He has served as a subject-matter expert, program coordinator and evaluator, and representative working with national-level organizations, such as FEMA, the USFA and the National Fire Academy. Rielage served as a committee member for NFPA 1250 and NFPA 1201. In 2019, he received the Ohio Fire Service Distinguished Service Award. Rielage is currently working on two books – “On Fire Service Leadership” and “A Practical Guide for Families Dealing with a Fire or Police LODD.” Connect with Rielage via email.